A 35-year-old male uremic patient developed the classical presentation of Reiter's syndrome after 3 years of regular hemodialysis. He had painful swelling of the left knee, sacroilitis, urethritis, balanitis, painless oral ulcers, acute uveitis and positive HLA-B27. Disease activity persisted and was aggravated although immune function studies showed depressed cellular immunity. The clinical course of this patient seemed to contradict our belief that activity of immunologically mediated disease will abate after uremia, but it concurred with the report that Reiter's activity was unchanged in AIDS despite the significant immunodeficiency of AIDS patients.